Department of Urology, University Hospitals Southampton NHS Trust, Southampton, UK.
Department of Surgery, University Hospitals Southampton NHS Trust, Southampton, UK.
BJU Int. 2021 Sep;128(3):361-365. doi: 10.1111/bju.15411. Epub 2021 May 5.
To look into the urology litigation trends and successful claims in the National Health Service (NHS) over the last 20 years.
We requested data from NHS Resolutions to investigate current litigation numbers, costs and causes for claims. Data collected included the number of claims dating from 1996 to 2019, the total sum of damages paid out each year for urology and the causes for the claims dating from 2009 to 2019. Data from NHS Resolutions were analysed, stratified and categorized by the authors from this information, which was provided as two separate documents.
The total cost of damages between 1997 and 2017 was £74.5m (range: £241 325-£7.8m per year). While the number of successful claims was 1653 (range 7-168 per year), the total number of claims was 3341 (range 31-347 per year) and, over time, this has increased almost sevenfold. The cost of damages has increased roughly in line with the number of claims. Over the last 10 years, non-operative-related claims accounted for 984 claims, of which the largest subset was for 'the failure to diagnose and/or treat' (n = 639, 65%), with 88 (9%) successful consent-related claims. There were 226 intra-operative-related claims. Of these, wrong-site surgery, a never-event, accounted for eight claims and there were six successful claims for failing to supervise juniors. A total of 1129 claims were postoperative claims, with retained foreign body or instrument accounting for 71 (6%) of these.
The number and cost of litigation claims have increased year on year. There is a need for continual improvement in patient care, surgical training, counselling, informed consent and early management of complications. The evidence reviewed in this paper suggests that the best approach to this is the combination of rigid adherence to and re-enforcement of common surgical guidelines and implementation of the national 'Getting it right first time' initiative.
研究过去 20 年英国国家医疗服务体系（NHS）中泌尿外科诉讼趋势和成功索赔案例。
我们向 NHS Resolution 请求数据，以调查当前的诉讼数量、成本和索赔原因。收集的数据包括 1996 年至 2019 年的索赔数量、每年泌尿科支付的损害赔偿金总额以及 2009 年至 2019 年的索赔原因。作者对 NHS Resolution 提供的两份单独文件中的数据进行了分析、分层和分类。
1997 年至 2017 年的损害赔偿金总成本为 7450 万英镑（范围：每年 241325 英镑至 780 万英镑）。虽然成功索赔案例为 1653 例（每年 7 至 168 例），但索赔总数为 3341 例（每年 31 至 347 例），且随着时间的推移，这一数字几乎增加了 7 倍。损害赔偿金成本与索赔数量大致呈正相关。在过去的 10 年中，非手术相关的索赔有 984 例，其中最大的一组是“未能诊断和/或治疗”（n=639，65%），有 88 例（9%）成功的与同意相关的索赔案例。还有 226 例手术中相关的索赔案例。其中，手术部位错误，一种本不应该发生的事件，占 8 例索赔，还有 6 例因未能监督初级医生而成功索赔。共有 1129 例术后索赔案例，其中遗留异物或器械占 71 例（6%）。
诉讼索赔的数量和成本逐年增加。需要不断提高患者护理、手术培训、咨询、知情同意和并发症早期管理的水平。本文回顾的证据表明，最好的方法是严格遵守和加强常见手术指南，并实施国家“首次就做对”倡议。
